Tuesday, April 26, 2005

I went in for a haircut about 10 days ago and I'm just not happy with it. I have a ton of hair, it is thick, and if I don't do much to it, it is curly. Usually, if I just leave it curly with a little gel, a quick blow dry and a toss it looks mostly okay. But sometimes, I like to actually take the time to fix it, which means blowing it out, using my big curling iron, getting it all pretty. Well, I have only tried it once since my hair cut and the right side of my head was curling under while the left side of my hair had a chunk flipping up. I did everything I normally do, and that piece flipped the wrong way. I have also done my usual, flip the head over, crunch it up, and leave it to be curly. Even that looks funny and my "long layers" that I have been striving for see to have gotten short on the top again. Ugh!When I first got out here a year and a half ago (yes, it has been that long), I started growing my hair out for Locks of Love, which is a charitable organization that helps make wigs for kids with cancer. It has to have a 10 inch ponytail in able to be accepted. About two hair cuts ago, I had my bottom layer nearly there but my top layers were no where close so I had to cut the bottom layer up to match things up. Since then the last two hair cuts I have gotten from my gal have just not been good. She also does my color and she is great at that. But I just haven't had a consistent cut from her the entire time I've been going to her.So, I'm breaking a sacred trust. I'm going to find someone else to cut my hair. And since I don't want to have to face my current stylist at my next color with a better haircut, I think I'm quitting her cold turkey. I know that is rude and cold, but it is my hair, I love my hair, and I'm just not happy. I have a goal, which bad haircuts aren't helping. Now, the task of finding someone new!

Monday, April 25, 2005

I just spent the last hour and a half on the phone with Osbasso attempting to write code to change things on my blog. What a royal pain in the ass! Who has time for this stuff?The sad thing is, I want to make it better. I have this crazy urge to keep tinkering. How disgustingly addictive! Now I want to change box colors, add links, add a daily comment box that changes. According to Os I need to edit my profile as it is "too long", but then I could paste it into another square. Just want I want to spend hours doing. This is about as time wasting as the link my best friend sent me today.http://n.ethz.ch/student/mkos/pinguin.swf will have you swatting the crap out of some poor penguin to watch him go bouncing across the ice on his belly or splatting head first into the ice. Sounds childish, right? It is but OH what fun after a stressful day of Mayo madness! So bear with me, the sight could all fall apart in some horrible catastrophe.

Sunday, April 24, 2005

"The Mayo Clinic Pharmacy intranet refill system is currently not working due to a catastrophic failure.We are unsure of the amount of time that this will not be available.To refill a prescription, please use the call-in refill system at (xx)x-xxxx.If you need to talk to a pharmacy representative, please call (xx)x-xxxx.We apologize for the inconvenience this causes. "

This was the statement that greeted me tonight when I logged on from home to the Mayo Web to refill my birth control pills. Normally, as an employee, I can log in, type in the prescription number and in about 6-8 hours my script is ready to pick up at the pharmacy of my choice as long as I remember to check the box as I click through the screen. Not tonight...I find a note of "catastrophic failure". Just one more demonstration of how well the employees at Mayo are cared for. Bad enough that I can't fill my birth controls at the hospital in which I work (St Mary's was founded by the Sisters of St Francis so no form of birth control can be filled at the hospital). I can hop on the shuttle and head downtown to pick them up, no big deal. But now the world famous, best technology in the world clinic can't keep their employee on-line prescription program running? And the choice of words. Really? Was this catastrophic? Yes, it is an inconvenience, but what happened? Did the server literally combust into flames? i highly doubt the catastrophic nature of the cause but oh, well. Guess I'll have to call for my refill in the morning.

Wednesday, April 20, 2005

I just feel the need to clarify what I do. I had A day at work today and all my feathers are ruffled. The biggest thing a fellow healthcare professional can do to piss me off is either imply that I don't know what I'm doing (i.e. not understand what I'm trained to do) or call me a nurse. Today...I had both of those thing happen more than once and I came home with fire rolling from my head.

So...I'm a PA-C. Granted the one's that need to read this never do and I don't want them reading my blog anyway because I bitch about them here. But....PA-C translates to Physician Assistant Certified. The title is over 30 years old and began in 1967 with four Navy Corpman who were put through Duke Medical school in TWO years instead of 4. The skipped the first year's worth of general biology classes, and to this days, one can not begin PA school without having a strong background in biology/chemistry classes as PA schools assume a knowledge of the topic, hence the reason I curriculum is shorter than med school. It is also assumes one has PRIOR medical knowledge. We are then put through an intense 24-36 month long program in which the first year focuses heavily on clinical based school work. In other words, we cover head to toe what could go wrong with the human body and how to treat it. The remaining time is spent in clinical rotations where we put to practice all we learned and begin seeing patients, diagnosing patients, and learning clinical skills under the direction of preceptors. Most programs are family practice focused but we also complete surgical training as well.

Upon graduation, a PA is licensed at the completion of his/her boards to examine patients, order tests which we determine appropriate, interpret those tests, perform minor surgical procedures independently, first assist in the operating room, and treat our patients. Now, I currently have a boss who believes I paid $100,000 (yes, that is what I owe in stupid loans) to follow a resident doctor around the clinic and enter their orders into the computer. Obviously, Dr. T is clueless and would prefer that I was "just a nurse" because then I wouldn't question thing so much. He has called my supervisor and told him I'm "too ambitious" at one point in time. I'm over that, we agree to disagree and I do what I'm trained to do with or without his approval.

Today, a nurse called from a nursing home as I had written orders for a patient's PICC line (percutaneously inserted central catheter) to be removed. This line run from one's arm to one's heart. It is basically a really long IV. He stated he had called the infusion therapy clinic and they didn't want to send a protocol to him but that they would talk him through it on the phone. He didn't like that answer so he called us to ask us to order an appt for the patient to have it pulled. I called him back, explained the protocol to him....pull until it comes out. Seriously, that simple. Only risk is that the tip of the catheter break off in the vein if you pull fast. He started loudly yelling at me that he wasn't going to assume responsibility if this patient died if something went wrong. He said he just couldn't accept that. So, he laid the phone down, and said to his supervisor "some nurse is telling me to just pull it". Well, the supervisor got on the phone and I quite clearly introduced myself just as I had to the gentleman as Nicolle Hendrix, PHYSICIAN ASSISTANT with OTS. Fuck him for calling me "just some nurse". I repeated the "pull until it is out" instructions, told her to check the catheter tip, if she needed to make herself feel sure, get a chest x-ray when done and call me back. She was fine with that, asked me to write an order so I wrote pull gently until catheter is removed, dictated a note to cover my ass, and later this afternoon called to see if they had had problems. She had gone home so I left a message.

Problem #2. I wrote physical therapy orders for a demented woman that has fallen three times in the last 2 months resulting in one surgery and two other sets of fractures. She has a knee cap fracture and because of her mental state is not a safe walker. I wrote orders for her to be ambulatory only for short distances with family or nursing staff (bed to chair, chair to bathroom). She is to get therapy once a day only to walk a longer distance, with therapy in her brace. Nurse called to tell me they had been walking her with nursing four times a day and how could I write orders to move her backwards right that. I repeated my exact orders, told her why and she hung up. Five minutes later she had the therapist call me to argue, I didn't even bother, handed the phone to Dr. Mabry and let him explain the exact same thing I had just said! When I write an order, I mean it!

So, if you or a loved one sees a PA, please do not call us a nurse. Understand we have completed intense and extensive clinical and surgical training, are licensed at a national level to examine, diagnosis, and treat you with the direct supervision of a physician that we can call on at any time (as required by law) for anything we feel is out of our scope of knowledge. Only question our orders if they seem absolutely absurd, such as a typo or we identified the wrong extremity (we don't do that often) but just like the doctor most have on a pedestal, we are human and will admit any mistake we do make (at least the good one's will).

Monday, April 18, 2005

Well...the fitness kick continues. Today I successfully completed a 14.2 mile bike without hyperventilating, collapsing, or seriously harming myself or others. That isn't the reason for the post. The bike ride actually felt really good by the end. It was a burn, but a good burn.

It was the Yoga DVD that I popped in once getting into the house that is working as my muse. Now, I don't want to go into a lot of details regarding why I felt the need to add yoga to my workout routine but it involves a male orientated conversation, of which details were shared with me. So, I'm attempting to be more bendy. If you have read my previous blog entries you know that I have been working with a personal trainer at the gym at Mayo. She's great. I meet with her every 6 weeks for a full fitness assessment and also see her a couple times of the week while I'm working out. The only portion of the assessment I consistently fail is the sit and reach. The same sit and reach from the Presidential Fitness Test back in grade school. I failed it then, I'm failing it now. My hips are shrinking, my waist is shrinking, my cardio health is great. When I wake up in the morning I can not reach my toes and only after multiple stretching breaks during the day and a good workout at the end of the day, can I reach my toes with a slight bend in my knees. HORRIBLE! Many of my male friends are quick to point out how bendy they are, including the boyfriend who also exclaims, "But you are a GIRL!"So long story short, I bought a beginner's instruction DVD and a yoga mat this weekend. I popped it in tonight and I'm off. The sitting poses felt great, moved through the three of them no sweat. 45 seconds into the first standing pose I have sweat dripping down my chest. It only gets better. As my back leg quivers as I attempt to bend over my front leg with one arm extended the instructor in her calm, quiet voice asks me to turn my now extended spine and look at my upward hand with my head. YEAH RIGHT! I nearly toppled into the coffee table behind me.

I made it through 5 of the standing poses and called it quits. Yes, I did feel like I had had a good stretch, but I was drenched in sweat, my legs felt weak. I'll try it again tomorrow. I know all the benefits of flexibility. I tell all my patients to do it, I'm just not very good at it. So, I'll try a bit each day and if this goes well my next goal would be a tantric yoga class. That is going to be a LONG time in the making, but I'm going at it with a positive attitude and hopefully I'll make some progress over the next three weeks before I meet up with Paula again at the gym :)

Friday, April 15, 2005

Someone is getting old! Now screw the bad connotations, with age comes wisdom gained from one's blunders in life, one's friendships, one's experiences in general. Osbasso turns 48 this week and all of those are true as he ages. For those of you who don't know him, he's not that bad of a guy. In fact, he would do pretty much anything for anyone if it would help that person out. he's been dealt some unfair hands in his life but he has taken each in stride, not wanting sympathy from anyone. "It happened, so I'll deal" is more his motto. On the other hand, he has had some amazing experiences in his life and has a group of friends to show off that anyone should be proud of. Those too he doesn't brag about, just shares the joy with those closest to him.Now without going into a lot of details, Osbasso has been there for me with unconditional love when I didn't feel very lovable, when I was balancing a lot of excitement with sheer fear, and when things have been really wonderful. No matter how deep shit has gotten, he has mucked me through it and when I've needed someone to celebrate with (like with too many beers at 2 in the afternoon when I finished my boards) he has always been there. He has also come to visit unannounced and once he paid his penance (dinner at my choice), it was a weekend of company that probably came just at the right time. So...today is his birthday and while he is getting on in years, he hasn't lost a step. He continues to be a geninue, laidback, always vigilant, trustworthy friend...and for that I am truly GRATEFUL. SO HAPPY BIRTHDAY OSBASSO!

Sunday, April 10, 2005

10 ENTIRELY RANDOM THINGS ABOUT ME1. I like haggis2. my dream vacation would be a backpacking trip in new zealand3. I love roller coasters, hate open water (unless I'm in a boat)4. I have met Jay Leno...and he put his hand on my bum5. I learned to tango from a hottie from Argentina when I was a senior in high school6. My favorite sammy is whole wheat, turkey, tomato, crumbled blue cheese, and ranch7. I talk to my cats like they were people8. My favorite vacation as a kid was weekend's at Grandma Rose's house9. My favorite Ben and Jerry's is the Coffee Heath Bar10. I want to fly a fighter jet for fun

9 WAYS TO WIN MY HEART1. Be honest2. Make me laugh3. Respect me4. Know when I need a hug...and give me one5. Challenge me6. Make me cry7. Let me be me, and like who I am because of that8. Be willing to show your true self to me9. Buy me circus cookies when I have a really bad day

Friday, April 08, 2005

Okay...i'm in a ranting mood after just having one of THE worst customer service experiences of my life. The part making it even worse is it was in a job which I personally have held. If I EVER treated my customers this way, God forgive me.

My friend M sent me an email this weekend asking me if I would accompany her to try on some new eyeglass frames as her prescription had changed and instead of just getting lenses she was thinking of getting new frames as well. I worked in optical between undergrad and grad school and very much liked my job. It was fun to help people pick out frames and I myself, have four pairs that I alternate between. The first place we went was Shopko, as M had already checked out her doc's office, Pearl Vision, and somewhere else. The tech at Shopko acknowledged us with a friendly greeting when we walked in the door, asked if she could help us, told us to get her if we needed anything, all while wearing professional casual dress with a crisp white coat. M tried on several frames, narrowed it down to four frames and from their two. We wrote down the names and headed to Target.

Now, I like Target. I give Target a lot of business. But tonight's experience would prevent me from personally going to, or even referring a friend to their optical department. A "young" lady was behind the desk, in khakis and a red T-shirt. Fine...it is Target. BUT, the shirt had a high school basketball logo on the chest and she was not wearing a name tag. Her hair was pulled into a lopsided braided pigtail. M and I proceeded trying on frames, this time finding three that she liked, narrowing it down to 1. The next task was to price the lenses, specifically the lenses she wanted--hi index with a specific anti-reflective coating. Not that complicated.

The tech requested M's prescription, took one look at it and rudely exclaimed, "Oh, honey, these are really bad". she did this while swiping at M's shoulder in a gesture of disgust. Before M could even ask about the lenses she wanted, said tech bubbled "Oh you should definitely do plastic, they would be SO much more attractive!" No individual serving the public should ever swipe at a patient, make reference to how poor their eyes are, and definitely not suggest the frames one has picked out our unattractive. So we ignored those comments and tried to get down to the business of what would it actually cost for the lenses requested. M asked some specifics about the anti-reflective coating, "What is it?" The tech's response (catch this...remembering she is trying to sell a product), "I don't know what crap they spray on it". She actually used the word "crap" in reference to a product the company she works for sells...maybe because she thinks it is crap but more likely because she didn't know her ass from a tea kettle.

She quickly dials what she says is "another store", the guy on the other end obviously asks why she is asking and she rolls her eyes at M, and fakes a smile as she drags out her response, "because this WONNNNDDDEERFFFUlll lady" wants to know. At this point, I'm ready to walk out, can't tell if M will follow. She hangs up, doesn't have a clue about the product, and is talking to us as though we are a group of teenagers hanging at the local Dairy Queen.

We leave, get half way to the door and decide we are angry enough to complain to customer service. you should have seen the manager's eyes. They go real big when I boldly suggested the gal shouldn't be working there anymore. After filling him on the above details, he immediately went to optical while M and I went around the other way. I would have loved to watch the ignorant young lady defend herself, half want to go back later this week and see if she still works there.

When did the younger generation (and I'm not much older than them) stop respecting others and especially when they are in a service role. Rule #1 Customer is always right, Rule #2 never argue with customer. Forgot to add the rule always respect the customer and never refer to a product in a medically related service as "crap". Don't know what else to say about this one! Grow up kids!

Tuesday, April 05, 2005

So I have been on this health kick now since mid-November. There were a few lapses due to the recurrent OTS chest cold that we so liberally share but I have now finally kicked it. I have had my initial meeting with my trainer way back when I first mentioned it on my blog and two weeks ago had my 6 week check-up with her. The Healthy Living Center provides trainers to us at no cost and without Paula, I'm not sure I would still be doing so well. Two weeks ago I had lost 4 lbs in 6 weeks and nearly just over 2.5 inches in my waist and hips. I had also increased my flexibility by 3 inches. That is my total downfall...I am NOT a bendy person! Gumby is not in my genes.Anyway...that was two weeks ago and with that news I felt pretty good about continuing with the program because I had the tangible results. The more subtle signs are the jeans and khakis that are gapping in the right places and getting loose. It is working. I just got home from the gym tonight and successfully completed 60 minutes of cardio divided between th PreCor upright bike and the crosstrainer. In between two the bike and the trainer I did 10 minutes of my core/abdomen work out that Paula worked out for me last week. I also did a good 15 minutes of stretching too.

I can't believe I'm going to say this, but after all that time in the last few months, I think i'm actually starting to LIKE going to the gym. Now those of you that know me, know that is not something I would normally admit too. But, I'm seeing a difference and while I can't admit to having a runner's high, once I actually get my bumm to the gym and get moving it feels really good. (I still think the gym is a torture chamber)

Sunday, April 03, 2005

After a couple years at this so called war, someone that I am familiar with has been killed. This is a true example of how small a world this is. When I found out I was moving to Rochester in November of 2003, my first thought was...I don't know anyone there. Heather shared the good news of me getting the job with the teacher's at Broadwater Elementary School. Karen, the school secretary, said she had family her and sent me the name of her niece. i only had three weeks before I headed cross country but during that time I sent Tonya emails back and forth. Once I made it here, I hadn't even been in Rochester for 24 hours when she came by, picked me up and showed me around town. We met for lunch or coffee several times during my first few months here. Over time, we didn't do much else together, she being a few years younger than I. But in the time that we did hang out, she talked a ton about her brother who was in Iraq in the Military Police. He always kept in touch via email and cell phone whenever he could. They were very close and from what I could tell, he was a pretty good guy.

On Holy Thursday, I got home from Mass and switched on the 10 pm news. I was only half watching but they mentioned that a local family had just learned of the death of their son. I looked up and their was Tonya with a picture of she and her mom with her brother. From there, I emailed Heather, who was in China but said she would have email. I wanted to email Karen but also didn't know if she knew yet and I didn't want to be the first to mention it. Heather emailed me back, just as upset as I was. Her third grade class had sent Travis packages and letters.

So, here we are still in Iraq, AFTER elections, still with soldiers dying every day. Now, don't get me wrong, I'm as patriotic as the next and I have been praying for the troops since day one of all of this. I still get chocked up at the National Anthem, I cry when they show military funerals on CNN. But, I still don't know if I can honestly say I support the decisions that have occurred that have resulted in our troops still being there. On days like this, as I broke into tears, hugging Travis' sister, that doubt is even greater. Funny, considering today's church readings are the gospel about Doubting Thomas.

I will continue to support every single troop that is over there, praying for their safety and their family but I will continue to strongly feel the need for our soldiers to be home. God Bless them all!

Military Police Officer Travis Bruce: Soldier, 22, killed in IraqSpc. Travis Bruce is city's first loss in warAssociated PressA military police officer from Rochester was killed in Iraq, relatives said Thursday.Spc. Travis Bruce, 22, was a 2002 graduate of Mayo High School and was serving in Baghdad when he was killed Wednesday morning. He was the first person from Rochester killed in the war, and the 20th Minnesotan to die in the Middle East since the conflict began.His family learned of his death Thursday morning. They said he was struck by a rocket-propelled grenade as he stood on the roof of a building he and his unit were guarding.Bruce joined the Army right out of high school three years ago. He was with the 42nd Military Police Brigade, based in Fort Lewis, Wash.This was his second tour of duty in Iraq. He left around Valentine's Day. He had been in the first wave of coalition forces that entered the region in March 2003 and served a one-year tour, mostly in Kuwait, his family said."Travis was very proud to be a soldier," Sue Ketchum, his aunt, told the Post-Bulletin newspaper.An American flag flew outside the Rochester apartment of Vickie Bruce, Travis' mother, and that's where relatives and friends gathered to grieve and share their recollections.They watched videos of a party thrown for Travis at the Holiday Inn over Christmas."It made us laugh and made us cry," Ketchum said."Travis was very soft-spoken and mild-mannered," she said. "Before he went in the military he was a young boy. He became a man. He knew himself, knew his capabilities and was really coming to terms with the important role he played."He came from a family of military police officers. His father, Kenneth Bruce, of Portland, Ore., retired from the Army 25 years ago. His great-uncle and grandfather were also MPs.Kenneth Bruce told KTTC-TV his son was a very good soldier. He said he spoke with his son's commanders in Iraq and they told him Travis was one of their best.John Frederickson, principal at Mayo High School, said he knew Travis Bruce well, and that he was a hard worker."He was just an average regular kid that worked in school and did what he needed to do," Frederickson told the station. "He had a large group of friends that liked him a lot and vice versa."The principal said the last time he saw Bruce was at the school in 2003."When he spoke at our Veterans Day assembly, his connection with the people that were in his unit, his fellow soldiers, that affection and that commitment to them was profoundly common. He was home on leave but at the same time very determined to get back with them."Word of Bruce's death was relayed to students over the public-address system a few minutes before school let out Thursday. The news "just knocked the wind out of me," said Steve Mohlke, a teacher who knew him.Bruce had hoped to return to the United States, next month to begin K-9 training in Texas. He intended to be a police officer or military recruiter after his days of active duty, Ketchum said.Funeral arrangements were pending. A memorial service was scheduled for Saturday in Iraq and also at Fort Lewis.A memorial fund has been set up at the Premier Banks in Rochester. Donations can be made to the Travis Bruce Memorial Fund.

About Me

I'm an adopted Montana native currently working as a physician assistant for the Department of Defense in Alaska. It's not Montana but it is better than SE Minnesota. My cats Reggie, Romeo, and Montana as well as Ruby, my chocolate lab, keep me entertained. I'm on a whole new adventure!